The Relationship between Age Feeding and Anemia in Pregnancy

THE RELATIONSHIP BETWEEN AGE FEEDING AND ANEMIA IN PREGNANCY

 

ABSTRACT

The study examined the prevalence of Anemia among pregnant women in Uyo Teaching Hospital. The objectives the study sought to achieve are to determine the prevalence, risk factors and adverse perinatal outcomes of anemia among pregnant women, to ascertain types and causes of anemia in pregnant women and also to suggest possible recommendations aimed at engendering relationships between age, feeding and Anemia in pregnancy.

To achieve these objectives, the study adopted survey research design while the population that agreed to this were 82 females and 0 male who attended the Uyo Teaching Hospital at the time. The sample size was 82 using random sampling method while collection instrument was research questionnaire. The collected data was analyzed with the aid of Statistical Package for Social Sciences (SPSS).

Findings of the study indicates that majority of the women in Uyo are aware of the prevalence of Anemia in pregnancy. The Uyo Teaching Hospital often carry out a seminar for pregnant women to teach them the Do’s and Don’ts of pregnancy and also to tell them more about Anemia during pregnancy. Feeding or Nutritional Dietary plays a vital role in pregnancy. It is advisable for pregnant women to get the proper diet in other to avoid unforeseen issues.

The common type of pregnancy is the Single Pregnancy Type, which puts women under minimum risk in dealing with anemia during pregnancy. Majority of pregnant women claimed it is important to get their HB percentage checked.

The Relationship between Age Feeding and Anemia in Pregnancy

 

CHAPTER ONE

INTRODUCTION

1.1   BACKGROUND TO THE STUDY

Anemia is defined as a decrease in red cell hemoglobin concentration in relation to age, sex, and geographical specifications. It is termed as one of the most common nutritional deficiency globally and affects more than 1.6 billion people worldwide. Of the estimated 1.6 billion people, 56 million are pregnant women.

Anemia in pregnancy affects about half of all pregnant women globally and constitutes an important global/reproductive health issue. The World Health Organization estimates that the prevalence of anemia in pregnancy varies from 53.8% to 90.2% in developing countries and 8.3% to 23% in developed countries.

According to the Centre for Disease Control and Prevention, anemia in pregnancy is defined as hemoglobin levels of less than 11 g/L (haematocrit less than 33%). Anemia in pregnancy ranges from mild (10.0–10.9 g/L or haematocrit of 30–32.9%), moderate (7–9.9 g/L or 21–29.9%) to severe (less than 7 g/L or less than 21%).

Maternal anemia is multifactorial with regard to possible causes. It could be physiological (haemdilution or/and increase in nutritional demands from the growing foetus), nutritional (deficiency of iron, vitamins, and other micronutrients), genetic (haemoglobinopathies), and infection-induced (malaria, intestinal infestation, tuberculosis, and HIV).

The morbidity and mortality rate of the mother/child pair resulting from maternal anemia is alarming. According to “The Saving Mothers Report (2010–2013),” 40% of maternal deaths in South Africa were associated with anemia. Foetal consequences associated with anemia in pregnancy include but are not limited to still-births, low weight babies, intrauterine growth restriction, and neonatal sepsis.

Anemia in pregnancy is common in developing countries and prevalence statistics required for its effective management and control is not adequately available in Nigeria. Thus, this study seeks to provide prevalence statistics of anemia in pregnancy for the study region, assay for its severity, and highlight some possible correlates.

Anemia has been recognized as the most common form of nutritional deficiency worldwide, particularly in developing countries like Nigeria and India. Though anemia is easily treatable and preventable disease, it continues to be significantly associated with pregnancy.

Diminished intake and increased demand, excess demand in case of multigravida woman and altered metabolism along with the background characteristics like low socioeconomic status, illiteracy, early age of marriage associated with increase in susceptibility to infectious diseases like hookworm infestations may serve to be the underlying factors associated with prevalence of anemia during pregnancy.

According to the World Health Organization (WHO) prevalence of anemia among pregnant women varies from 14% in developed countries to 65%–75% in Nigeria. In women, anemia may become the underlying cause of maternal mortality and perinatal mortality.

Hemoglobin value <11 g/dL is defined as anemia in pregnancy by WHO. Anemia in pregnancy can be further divided as mild, moderate and severe anemia for hemoglobin level 10.0–10.9 g/dL, 7–9.9 g/dL and severe <7 g/dL.

Various studies showed an association between anemia and maternal mortality. Apart from maternal mortality, anemia in pregnancy may result in intrauterine growth retardation, low birth weight, still-birth, and neonatal death.

In view of low dietary deficiency of iron and folic acid, and high prevalence of anemia among pregnant women, the National Nutritional Anemia Prophylaxis Program (NNAPP) was established to prevent anemia among pregnant women. Through this program 100 mg of ferrous iron and 500 mcg folic acid tablets distributed to pregnant woman through Urban Family Welfare Centers in urban areas and Primary Health Centers in rural areas. Despite of these preventive measures, anemia in pregnant women is still very much prevalent in Uyo.

The key for safe motherhood is reduction of maternal anemia. The risk factors of anemia particularly during pregnancy are multifactorial and complex. So, knowledge of these risk factors and compliance of respondents towards implemented government program is very much essential to prevent anemia and its consequences.

Primary health care physicians are the first contact physician in the community who can play a very important role in identification and treatment of anemia. Many issues associated with anemia can be assessed and modified at the primary care level such as dietary habits, multi parity etc.

In most studies conducted in Africa, the majority of those who were anemic were pregnant women aged 20–24 years, having a primary level of education, married, with the lowest wealth index. It was discussed in many studies that a low level of education might increase the chance of someone getting anemia due to the fact that educated women have a greater chance of getting proper information in relation to health issues like anemia. Also being educated may influence someone to comprehend the information that is provided at the ANC.

The wealth status of women was also considered to be among the predicators of anemia in pregnancy, since pregnant women with low to middle wealth index were considered not able to get enough number of meals. These findings look similar to the findings from several studies conducted in Ethiopia, Ghana, and Malaysia which also indicate that pregnant women wealth status and occupation may contribute to anemia.

Anemia among pregnant women was found to be statistically significant with pregnancy in the third trimester. Studies show that there is an increase in blood volume during pregnancy time which may lead to a decrease in iron storage. As the number of trimesters increases, the demand for iron in the body also increases therefore, there is a great chance for those who are in the third trimester to develop anemia compared to those in the first trimester. These findings are supported by the studies done in a tertiary referral hospital, Northern Ghana, and Pumwani Maternity Hospital, Kenya.

The study also found that anemia was more prevalent in women who started their ANC visits in the second or third trimester. These women are likely to get iron and folic acid supplementation for a shorter duration during pregnancy as compared to those who started attending ANC earlier. This may have contributed to the high prevalence of anemia recorded in this study. The association was statistically significant.

Not consuming vegetables, meat, eggs, and fish were significantly associated with being anemic. This can be due to the fact that these are iron-rich foods and, hence, little or no consumption of these foods can be an important contributor to anemia. The studies done in the Volta Region, Ghana, and northern central Ethiopia support these findings. Inadequate intake of micro nutrients in food-insecure households can be a result of under-consumption of food or over consumption of energy-dense but nutrient-poor diet which are becoming increasingly cheaper sources of calories for consumers who are poor.

The current study also reported inadequate dietary diversity, which was significantly associated with anemia. Food diversity is advised to pregnant women since it is a period which demands physiologically higher nutrition than usual. Similar findings were reported from the study done in West Ethiopia and from Southern Ethiopia. Other contributing factors to higher prevalence may be low income and the number of children.

 

Age Feeding and Anemia in Pregnancy

1.2     STATEMENT OF PROBLEM

Severe anemia (<7 g/L) during pregnancy has been associated with major maternal and fetal complications. It increases the risk of preterm delivery, low birth weight, intrauterine fetal death, neonatal death, maternal mortality, and consequently infant mortality.

Anemia has multifactorial etiology and risk factors; particularly in developing countries, with substantial differences in known risk factors within and between the regions of the same country. Research findings have revealed that determinants of anemia vary from place to place.

This highlights the importance of determining the problem-based factors associated with anemia using a strong study design in order to obtain local data in at-risk regions, specifically in the developing world.

Therefore, this study was carried out with the objective of determining the risk factors associated with anemia among pregnant women attending antenatal care services and to also know the relationship between age, feeding and Anemia in university of Uyo Teaching Hospital in Nigeria.

 

1.3       AIM AND OBJECTIVES OF STUDY

The general objective of the study is to examine the relationship between age, feeding and anemia in pregnancy. The objectives of the study are to:

1.  determine the prevalence, risk factors, and adverse perinatal outcomes of anemia among pregnant women
2.  study the prevalence of anemia, types and causes of anemia in pregnant women
3. suggest possible recommendations aimed at engendering relationship between age, feeding and anemia in pregnancy.

 

1.4       RESEARCH QUESTIONS

The following questions are developed to guide the study.

1. what determines risk factors and adverse perinatal outcomes of anemia among pregnant women?
2. what are the prevalence, types and causes of anemia in pregnant women?
3. what are the possible recommendations aimed at engendering the relationship between age, feeding and anemia in pregnancy.

 

1.5   SIGNIFICANCE OF THE STUDY

The significance of this study lies in the application of its findings for operational findings. It is believed that this study will be of immense importance because the empirical findings will review not only the relationship between age, feeding and anemia in pregnancy but also it will offer preventive measures to take when dealing with this.

The study among others, seek to identify the causes and types of various variables related to anemia in pregnancy. It’s the researcher’s belief that this work through its findings will change the perception of the relationship between age, feeding and anemia in pregnancy and its preventives. Scholars and practitioners suggest that knowing the causes and types of anemia in pregnancy can facilitate the improvement of preventive performance when faced with such challenges.

The relevance of this study stem from the important role age, feeding and anemia has to in pregnancy in women in Uyo in particular and Nigeria in general. The findings of this study would be of great value to the University of Uyo Teaching Hospital Nigeria because the study will highlight the causes, types and preventive measures to be taken when dealing with anemia in pregnancy.

The result of this study will also help health workers in their professional roles to become conscious of their roles as the propelling force towards creating curbing measures for anemia in pregnancy. It is hoped that the research findings will assist the federal, state and local government health sector on how to adopt adequate preventives that can help them in curbing this issues.

It is also believed that the work will stimulate further interests in future researchers who will be involved in the research effort in the health sector. In addition to the above, it will add to already existing literatures on the relationship between age, feeding and anemia in pregnancy which will serve as reference materials to scholars and researchers who may be interested in embarking on a research of this nature.

 

 1.6     SCOPE OF THE STUDY

This study examines the relationship between age, feeding and anemia in the University of Uyo Teaching Hospital in Akwa Ibow, Nigeria.

However, to facilitate a sound grasp of the subject matter within the thought frame of the objectives of the study, the scope of the study covered such issues as the concept of pregnancy, anemia, relationship between age, feeding and anemia in pregnancy among other concepts which would be clearly listed and discussed in this research work.

The Nexus between Age Feeding and Anemia in Pregnancy

1.7    LIMITATION OF STUDY

In conducting this research project, the major limitation to research work in this part of the country is the inability of the researcher to get the necessary information which could have made the work richer were not obtained due to unwillingness of some health officials to give out rich and adequate information so the researcher resorted to getting the little she could get from the internet and from staffs who were willing to share their knowledge with her.

However, in spite of all these information and other constraints which may not be mentioned here, it does not in any way affect the reliability of the research.

 

1.8   DEFINITION OF TERMS

PREGNANCY: Pregnancy is the term used to describe the period in which a fetus develops inside a woman’s womb or uterus. Pregnancy usually lasts about 40 weeks, or just over 9 months, as measured from the last menstrual period to delivery

ANEMIA: Anemia is defined as a hemoglobin concentration below a specified cut-off point; that cut-off point depends on the age, gender, physiological status, smoking habits and altitude at which the population being assessed lives. WHO defines anemia in children aged under 5 years and pregnant women as a hemoglobin concentration <110 g/L at sea level, and anemia in non-pregnant women as a hemoglobin concentration <120 g/L.

HEMOGLOBIN:A protein inside red blood cells that carries oxygen from the lungs to tissues and organs in the body and carries carbon dioxide back to the lungs. Testing for the amount of hemoglobin in the blood is usually part of a complete blood cell (CBC) test.